In response to Michele's situation, in which she was denied payment for a stem cell transplant because it was "experimental," Karen says it is a catch-22 that many people face. "Employers don't purchase coverage for experimental procedures. Medicare doesn't cover experimental procedures. Many foreign countries don't cover experimental procedures," she says.
Karen says that if you think a mistake has been made in the claims process, you can dispute it. "If you have a decision that doesn't make sense to you that you think is wrong, you should be appealing," she says. According to Karen, you can call the phone number listed on the back of your insurance form in order to contact the company.
Although Karen admits that America's current healthcare system has its faults, she says a government takeover is not the answer. "There's no perfect system. What we need to do is craft something that's uniquely American. We have to take responsibility in insurance plans of doing a better job dealing with mistakes, dealing with people who are falling in the cracks, good physicians and good hospitals," she says.